Sarcoidosis is a chronic inflammatory condition that involves the growth of small collections of white blood cells in various parts of the body; most commonly in the lungs, lymph nodes, joints, eyes and skin. Researchers believe that the condition results from the body’s immune system responding to an unknown substance—most likely something inhaled from the air.
Sarcoidosis is a very rare condition in children. Certain factors may increase a child's likelihood for developing the condition:
- Race. African-Americans are about 10 times more likely to develop sarcoidosis than are Caucasians. Also, the condition is more likely to be more severe and cause lung problems in African-Americans.
- Family history. Although no gene has been identified as the cause of sarcoidosis, research has shown that a child is two to three times more likely to develop sarcoidosis if someone in his or her family has the condition.
The most common symptoms of sarcoidosis in children are uveitis (inflammation of the middle layer of the eye), arthritis and unexplainable rashes. Other early symptoms of sarcoidosis include:
- Swelling or pain in the joints
- Difficulty moving the joints
- Swollen lymph nodes
- Weight loss
Nearly all children affected by sarcoidosis eventually have lung problems such as:
- Persistent dry cough
- Shortness of breath
- Chest pain
Many children who have the condition also develop skin problems such as:
- Rash. Children with sarcoidosis can develop a rash (often on the shins or ankles) of red or reddish-purple bumps that may be warm or tender to the touch.
- Lesions. Children with the condition may develop disfiguring skin sores, often on the nose, cheeks and ears.
- Color change. Some areas of skin can get darker or lighter in color.
- Nodules. Children with sarcoidosis can develop growths just under the skin, often around scars.
Some children with sarcoidosis have symptoms related to their eyes, including:
- Blurred vision
- Eye pain
- Severe redness
- Sensitivity to light
Diagnosis of Sarcoidosis
Sarcoidosis can be difficult to diagnose, because the condition produces few symptoms in its early stages and can affect any system in the body. In order to accurately diagnose sarcoidosis, doctors at Riley at IU Health perform one or more of the following tests:
- Physical exam. The doctor will begin with a physical exam, including a thorough examination of any skin lesions, the heart, the lungs and the lymph nodes.
- X-ray. Your child’s doctor may use an X-ray to check for lung damage or inflamed lymph nodes.
- Computed tomography (CT). Your child’s doctor may use a noninvasive CT scan to obtain a closer look at the lung tissue and lymph glands.
- Positron emission tomography (PET). A type of nuclear medicine imaging called positron emission tomography (PET) can help your child’s rheumatologist determine the exact location and amount of inflammation in the body.
- Magnetic resonance imaging (MRI). Your child’s doctor may use magnetic resonance imaging if sarcoidosis appears to be affecting either the heart or brain and nervous system.
- Blood test. A sample of your child’s blood may be analyzed to check kidney and liver function. There are a couple of enzymes that might be higher in the blood of people with sarcoidosis than healthy people. If the enzyme level is high, that supports the diagnosis. However, if the enzyme level is not high, it still could be sarcoidosis.
- Pulmonary function test. Your child’s lungs can be assessed for volume and the amount of oxygen the lungs deliver to the blood.
- Eye exam. An eye exam can check for any unexplained inflammation or vision problems that are associated with sarcoidosis.
- Biopsy. Your child’s doctor may take a biopsy (small sample of tissue) from an affected area of the body to check for granulomas (inflammation) commonly seen under the microscope in this condition.
Children who have signs and symptoms of sarcoidosis may need one or more of the following treatments:
- Corticosteroids. These anti-inflammatory medicines are sometimes applied directly to the skin as a cream, inhaled into the lungs using an inhaler or swallowed as a pill or liquid.
- Anti-rejection medicines. Anti-rejection medicines are used to suppress the immune system, which reduces overall inflammation.
- Antimalarial medicines. Antimalarial medicines have been shown to be helpful for skin disease, nervous system involvement and elevated blood calcium levels.
- Tumor necrosis factor-alpha (TNF-alpha) inhibitors. Commonly used to treat inflammation associated with rheumatoid arthritis, TNF-alpha inhibitors are injectable medicines that can be used to treat sarcoidosis when the patient is not responding to other treatments.
- Transplant surgery. A lung transplant or liver transplant may be considered if the condition has caused severe damage to that organ.
There is no cure for sarcoidosis, but the condition often goes away on its own. However, in some patients, the signs and symptoms of sarcoidosis can last for many years and lead to organ damage.
Key Points to Remember
Key Points to Remember
- Sarcoidosis is a very rare condition in children that involves the growth of small collections of white blood cells in various parts of the body.
- Common symptoms of pediatric sarcoidosis are inflammation in the eye, arthritis and unexplainable skin rashes.
- Sarcoidosis eventually affects the lungs in nearly all patients. If the condition does enough damage, a lung transplant may be necessary.
- Children who are African-American or have a family history of sarcoidosis are more likely to develop the condition.
Support Services & Resources
Support Services & Resources
Visit the trusted websites below to learn more about sarcoidosis.
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.